1

Creation of a protective barrier around orthodontic brackets.

Risk Factors Orthodontic BracketsAn increased caries risk is present in orthodontic patients with fixed brace appliances. This is because the brackets and archwires act as additional retention sites for food and bacteria, affect the natural flow of saliva in the mouth and hinder effective tooth brushing. Therefore, a specific oral care concept is required. One of the preventive measures for patients with orthodontic brackets carried out in our international practice for paediatric dentistry is the use of 3M™ Clinpro™ XT Varnish Durable Fluoride-Releasing Coating as a protective coating for high-risk, caries-prone areas.

3MSM Health Care Academy

Protective CoatingThis liquid/paste glass ionomer coating offers sustained

fluoride and calcium phosphate release. It can be

recharged by the use of fluoride tooth paste and remains

on the tooth surface for at least six months. As confirmed

by in-vitro studies, the specific formulation leads to the

creation of a caries inhibition zone in the areas under

and around the coating. [1] The application of the varnish

as a site-specific protective coating around brackets

is demonstrated using the following patient case.Figure 1 : Patient with orthodontic brackets shortly after their placement. The tooth surface around the brackets is cleaned with a rubber brush.

Date of Original: February 2015 - Espertise Magazine

by Dr. Jacqueline Esch

23MSM Health Care Academy

Figure 4 : Removal of pooled water on the surfaces around the orthodontic brackets with air. The tooth should still be slightly moist afterwards.

Figure 5 : Application of 35% phosphoric acid etchant to the enamel surfaces. The recommended etching time is 15 to 60 seconds.

Figure 6 : Thorough rinsing with air/water spray for complete removal of the etchant.

Figure 7 : A small amount of 3M™ Clinpro™ XT Varnish is dispensed onto the mixing pad. The Clicker™ Dispenser ensures that the correct mixing ratio is obtained.

Figure 8 : Mixing paste and liquid components with a small spatula for a homogeneous resultwith smooth consistency. The optimal mixing time is 10 to 15 seconds.

Figure 2 : For optimal removal plaque and debris, 3M™ Clinpro™ Prophy Paste may be used. A cleaning medium containing oils is not indicated.

Figure 3 : Thorough removal of the polishing paste by rinsing with water.

Figure 9 : Application of the glossy coating to the vestibular tooth surfaces around the orthodonticbrackets with a brush. The layer should not be thicker than 0.5 mm. Contact with thesoft tissues should be avoided.

33MSM Health Care Academy

For more information on the 3M materials utilised in this case, please visit 3M.com.au or 3M.co.nz, or contact your local 3M Product Specialist.

Dr. Jacqueline EschDr. Jacqueline Esch graduated from the University of Regensburg (Germany) in 1991. She worked as an assistant teacher at the University of Regensburg for 6 years. In 1997 she joined a private practice for paediatric dentistry in Munich, where she developed a keen interest in all aspects of paediatric dentistry including the treatment of anxious patients, advanced tooth decay, paediatric crowns and treatment under nitrous oxide. In 2000 she completed a continuing education program in Newark, NJ (USA) with Prof. M. Haupt.

Since 2003 she’s been a Specialist for Paediatric Dentistry and co-owner of the continuing education center for paediatric dentistry in Munich. She is an active member of the EAPD, engaged in several commissions and since 2012 a fellow of the Pierre Fauchard Academy. Dr. Esch is giving lectures internationally and leading certified courses for conscious sedation.

Figure 10 : Light-curing of each area for 20 seconds. In areas without exposure to the curing light, the delayed auto-setting mechanism of the coating ensures a complete cure.

OutcomeThe result of this treatment is a protective coating of the tooth

surfaces with increased risk for caries or white spot lesions.

For an ideal effect, the application should be repeated after

six months. At any time, it is possible to remove the coating by

cleaning the tooth surfaces with a coarse prophy paste. In our

experience, the described application of Clinpro™ XT Varnish

is an effective preventive measure for high-risk, caries-prone

areas including around fixed orthodontic brackets and acid

erosion-prone surfaces.

Contact: Dr. med. dent. Jacqueline Esch info@kinderzahnaerzte.com

43MSM Health Care Academy

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North Ryde NSW 2113

Ph: 1300 363 454

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3M Oral Care

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Disclaimer: Application and Technique guides used in this case on 3M products may not always align with 3M Product Instructions for Use. Please always follow the 3M Product Instructions For Use for best clinical results.